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Alcohol Screening and Counseling

An effective but underused health service

January 2014

38 Million

1 in 6

Only 1 in 6 adults talk with their doctor, nurse, or other health professional about their drinking.

25%

Alcohol screening and brief counseling can reduce the amount consumed on an occasion by 25% in those who drink too much.

At least 38 million adults drink too much and most are not alcoholics. Drinking too much includes binge drinking, high weekly use, and any alcohol use by pregnant women or those under age 21. It causes about 88,000 deaths in the US each year, and costs the economy about $224 billion. Alcohol screening and brief counseling can reduce drinking on an occasion by 25% in people who drink too much, but only 1 in 6 people has ever talked with their doctor or other health professional about alcohol use. Talking with a patient about their drinking is the first step of screening and brief counseling, which involves:

Using a set of questions to screen all patients for how much and how often they drink.

Counseling patients about the health dangers of drinking too much, including women who are (or might be) pregnant.

Referring only those few patients who need specialized treatment for alcohol dependence.

Doctors and other health professionals can use alcohol screening and brief counseling to help people who are drinking too much to drink less. The Affordable Care Act requires new health insurance plans to cover this service without a co-payment.

Issue Details

Problem

Doctors, nurses, and other health professionals should screen all adult patients and counsel those who drink too much.

Most adults have not talked with a doctor, nurse, or other health professional about how much they drink.

Public health experts recommend alcohol screening and counseling should happen more often than it does. Yet, people report a doctor, nurse, or other health professional has rarely talked with them about alcohol, the important first step for addressing problems with drinking too much:

Only 1 in 6 adults have discussed their drinking.

Few binge drinkers (1 in 4) have talked about alcohol use. Binge drinking is defined as men drinking 5 or more alcoholic drinks or women drinking 4 or more, in about 2-3 hours.

Even among adults who binge drink 10 times or more a month, only 1 in 3 have discussed drinking.

Only 17% of pregnant women have talked about drinking.

Most states had less than 1 in 4 adults who discussed their drinking. Washington, D.C. had the highest percentage with 25%.

Alcohol screening and brief counseling has been proven to work.

It can reduce how much alcohol a person drinks on an occasion by 25%.

It improves health and saves money just as blood pressure screening, flu vaccines, and cholesterol or breast cancer screening.